Individual
NICOLE PRYOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1155 N MAYFAIR RD, MILWAUKEE, WI 53226-3462
(414) 955-8900
(414) 955-6285
Mailing address
1155 N MAYFAIR RD, MILWAUKEE, WI 53226-3462
(414) 955-8900
(414) 955-6285
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
17521-130
WI
101YM0800X
Mental Health Counselor
Primary
2779-226
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538525308
—
WI
Enumeration date
01/11/2016
Last updated
02/04/2022
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